What are the best treatment options for hyperhidrosis (excessive sweating) of the axillae (armpits) and forehead?

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From the Research

The most effective treatment options for hyperhidrosis of the armpits and forehead include botulinum toxin injections, oral anticholinergic medications, and topical aluminum chloride, with botulinum toxin injections being the most recommended second-line treatment for axillary hyperhidrosis, as stated in the study by 1. When considering treatment options for hyperhidrosis, it's essential to evaluate the severity of the condition and the patient's medical history.

  • For axillary hyperhidrosis, botulinum toxin injections are recommended as a second-line treatment, as they provide excellent relief, lasting 4-6 months, by blocking the nerve signals that stimulate sweat glands 1.
  • Oral anticholinergic medications, such as glycopyrrolate (1-2mg twice daily), can effectively reduce sweating throughout the body, though they may cause side effects like dry mouth, blurred vision, and urinary retention 1.
  • Topical aluminum chloride is recommended as a first-line treatment for axillary hyperhidrosis, as it is a quick and easy application, although it may cause skin irritation and has a short half-life 2.
  • For craniofacial hyperhidrosis, oral medications, such as glycopyrrolate or clonidine, are considered first-line therapy, while topical medications or botulinum toxin injections may be useful in some cases 1. It's crucial to note that hyperhidrosis treatment typically requires trial and error to find the most effective approach with minimal side effects for each individual.
  • Iontophoresis, which uses a mild electrical current through water, works better for hands and feet than for axillae or forehead, and is considered a third-line therapy for palmoplantar hyperhidrosis 1.
  • For severe cases unresponsive to other treatments, endoscopic thoracic sympathectomy surgery may be considered for upper body hyperhidrosis, though it carries risks of compensatory sweating elsewhere 1, 2.

References

Research

Treatment options for hyperhidrosis.

American journal of clinical dermatology, 2011

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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